[Idiopathic scoliosis and pneumonia complicated with cor pulmonale. Report of one case].
A 10-year-old boy with idiopathic scoliosis presented with exertional dyspnea, lower leg edema since two weeks prior to admission. Physical examination revealed neck venous engorgement, moist rales, mild hepatomegaly, ascites and lower leg edema in addition to the scoliosis. Chest x-ray films showed cardiomegaly, pulmonary congestion and pneumonic infiltration of both lower lobes with bilateral pleural effusion. Electrocardiograms showed right axis deviation and right atrial hypertrophy. Two-dimensional echocardiography revealed dilatation of the right heart chambers and pulmonary artery. He was treated initially with mechanical ventilation, antibiotics, bronchodilators, diuretics, vasodilators, and digoxin with improvement. Unfortunately the patient became comatose after an episode of cardiopulmonary arrest. He did not recover from this tragedy and was discharged against medical advice in comatose state. Scoliosis may be complicated with pneumonia and cor pulmonale in children. Early surgical correction of the scoliosis may prevent the development of cor pulmonale. Combined medical and surgical managements should be carried out aiming at scoliotic heart disease.
Shiau
J C
JC
Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Wong
K S
KS
Huang
S C
SC
D002648:Child; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000150:complications*; D011660:Pulmonary Heart Disease / Q000209:etiology* / Q000628:therapy; D012600:Scoliosis / Q000150:complications*